Self‐managing illicit stimulant use: A qualitative study with patients receiving injectable opioid agonist treatment

2020 ◽  
Vol 39 (7) ◽  
pp. 914-923 ◽  
Author(s):  
Heather Palis ◽  
Scott Harrison ◽  
Scott MacDonald ◽  
David C. Marsh ◽  
Martin T. Schechter ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Opioid Agonist ◽  
Opioid Agonist Treatment ◽  
Stimulant Use

scholarly journals Exploring the effectiveness of dextroamphetamine for the treatment of stimulant use disorder: a qualitative study with patients receiving injectable opioid agonist treatment

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Heather Palis ◽  
Kirsten Marchand ◽  
Gerald “ Spike” Peachey ◽  
Jordan Westfall ◽  
Kurt Lock ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Research Question ◽  
Substitution Effect ◽  
Opioid Use ◽  
Opioid Agonist ◽  
Opioid Agonist Treatment ◽  
Stimulant Use ◽  
Practice Elements ◽  
Concurrent Use ◽  
Wide Range

Abstract Background A high proportion of people receiving both oral and injectable opioid agonist treatment report concurrent use of stimulants (i.e. cocaine and or amphetamines), which has been associated with higher rates of continued illicit opioid use and treatment dropout. A recent randomized controlled trial demonstrated the effectiveness of dextroamphetamine (a prescribed stimulant) at reducing craving for and use of cocaine among patients receiving injectable opioid agonist treatment. Following this evidence, dextroamphetamine has been prescribed to patients with stimulant use disorder at a clinic in Vancouver. This study investigates perceptions of the effectiveness of dextroamphetamine from the perspective of these patients. Methods Data were collected using small focus groups and one-on-one interviews with patients who were currently or formerly receiving dextroamphetamine (n = 20). Thematic analysis was conducted using an iterative approach, moving between data collection and analysis to search for patterns in the data across transcripts. This process led to the defining and naming of three central themes responding to the research question. Results Participants reported a range of stimulant use types, including cocaine (n = 8), methamphetamine (n = 8), or both (n = 4). Three central themes were identified as relating to participants’ perceptions of the effectiveness of the medication: 1) achieving a substitution effect (i.e. extent to which dextroamphetamine provided a substitution for the effect they received from use of illicit stimulants); 2) Reaching a preferred dose (i.e. speed of titration and effect of the dose received); and 3) Ease of medication access (i.e. preference for take home doses (i.e. carries) vs. medication integrated into care at the clinic). Conclusion In the context of continued investigation of pharmacological treatments for stimulant use disorder, the present study has highlighted how the study of clinical outcomes could be extended to account for factors that contribute to perceptions of effectiveness from the perspective of patients. In practice, elements of treatment delivery (e.g. dosing and dispensation protocols) can be adjusted to allow for various scenarios (e.g. on site vs. take home dosing) by which dextroamphetamine and other pharmacological stimulants could be implemented to provide “effective” treatment for people with a wide range of treatment goals and needs.

Exploring the effectiveness of dextroamphetamine for the treatment of stimulant use disorder: a qualitative study with injectable opioid agonist treatment patients

2021 ◽  
Author(s):  
Heather Palis ◽  
Kirsten Marchand ◽  
Gerald Spike Peachey ◽  
Jordan Westfall ◽  
Kurt Lock ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Research Question ◽  
Substitution Effect ◽  
Opioid Use ◽  
Opioid Agonist ◽  
Opioid Agonist Treatment ◽  
Stimulant Use ◽  
Practice Elements ◽  
Concurrent Use ◽  
Wide Range

Abstract Background: A high proportion of people receiving both oral and injectable opioid agonist treatment report concurrent use of stimulants (i.e. cocaine and or amphetamines), which has been associated with higher rates of continued illicit opioid use and treatment dropout. A recent randomized controlled trial demonstrated the effectiveness of dextroamphetamine (a prescribed stimulant) at reducing craving for and use of cocaine among patients receiving injectable opioid agonist treatment. Following this evidence, dextroamphetamine has been prescribed to patients with stimulant use disorder at a clinic in Vancouver. This study investigates perceptions of the effectiveness of dextroamphetamine from the perspective of these patients.Methods: Data were collected using small focus groups and one-on-one interviews with patients who were currently or formerly receiving dextroamphetamine (n=20). Thematic analysis was conducted using an iterative approach, moving between data collection and analysis to search for patterns in the data across transcripts. This process led to the defining and naming of three central themes responding to the research question. Results: Participants reported a range of stimulant use types, including cocaine (n=8), methamphetamine (n=8), or both (n=4). Three central themes were identified as relating to participants’ perceptions of the effectiveness of the medication: 1) achieving a substitution effect (i.e. extent to which dextroamphetamine provided a substitution for the effect they received from use of illicit stimulants); 2) Reaching a preferred dose (i.e. speed of titration and effect of the dose received); and 3) Ease of medication access (i.e. preference for take home doses (i.e. carries) vs. medication integrated into care at the clinic).Conclusion: In the context of continued investigation of pharmacological treatments for stimulant use disorder, the present study has highlighted how the study of clinical outcomes could be extended to account for factors that contribute to perceptions of effectiveness from the perspective of patients. In practice, elements of treatment delivery (e.g. dosing and dispensation protocols) can be adjusted to allow for various scenarios (e.g. on site vs. take home dosing) by which dextroamphetamine and other pharmacological stimulants could be implemented to provide “effective” treatment for people with a wide range of treatment goals and needs.

scholarly journals Evidence of increased Fentanyl use during the COVID-19 pandemic among opioid agonist treatment patients in Ontario, Canada

2021 ◽  
Vol 90 ◽  
pp. 103088
Author(s):  
Kristen A. Morin ◽  
Shreedhar Acharya ◽  
Joseph K. Eibl ◽  
David C. Marsh
Keyword(s):  
Opioid Agonist ◽  
Opioid Agonist Treatment

scholarly journals Opioid agonist treatment and patient outcomes during the COVID ‐19 pandemic in south east Sydney, Australia

2021 ◽  
Author(s):  
Nicholas Lintzeris ◽  
Rachel M. Deacon ◽  
Victoria Hayes ◽  
Tracy Cowan ◽  
Llewellyn Mills ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Opioid Agonist ◽  
Opioid Agonist Treatment ◽  
Sydney Australia

scholarly journals Scoping review protocol: the use of telemedicine in providing opioid agonist treatment and related psychosocial supports

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040556
Author(s):  
Des Crowley ◽  
Robyn Homeniuk ◽  
Ide Delargy
Keyword(s):  
Scoping Review ◽  
Psychosocial Support ◽  
Descriptive Analysis ◽  
Cochrane Library ◽  
Opioid Use ◽  
Opioid Agonist ◽  
Opioid Agonist Treatment ◽  
Search Terms ◽  
Medical Librarian ◽  
The Cochrane Library

IntroductionThe global opioid-related disease burden is significant. Opioid agonist treatment (OAT) can be effective in reducing illicit opioid use and fatal overdose, and improving multiple health and social outcomes. Despite evidence for its effectiveness, there are significant deficits in OAT globally. COVID-19 has required rapid adaptation of remote models of healthcare. Telemedicine is not used routinely in OAT, and little is known about the current levels of use and effectiveness. The objective of this review is to describe models of telemedicine and their efficacy.Methods and analysisThis scoping review uses the review methodology described by Arksey and O’Malley and adapted by Levac et al. The search strategy developed by the medical librarian at the Irish College of General Practitioners in conjunction with the research team will involve five databases (PubMed, EMBASE, the Cochrane Library, PsycInfo and OpenGrey) and the hand searching of reference lists. A limited initial search of two databases will be completed to refine search terms, followed by a second comprehensive search using newly refined search terms of all databases and finally hand searching references of included studies. To be included, studies must report on remote ways of providing OAT (including assessment, induction and monitoring) or related psychosocial support; be published in English after 2010. Two researchers will independently screen titles, abstracts and full-text articles considered for inclusion. Data will be extracted onto an agreed template and will undergo a descriptive analysis of the contextual or process-oriented data and simple quantitative analysis using descriptive statistics.Ethics and disseminationResearch ethics approval is not required for this scoping review. The results of this scoping review will inform the development of a national remote model of OAT. The results will be published in peer-reviewed journals and presented at relevant conferences.

scholarly journals Nontraditional Alcohol and Opioid Agonist Treatment Interventions

2018 ◽  
Vol 102 (4) ◽  
pp. 683-696 ◽  
Author(s):  
Christopher Fairgrieve ◽  
Nadia Fairbairn ◽  
Jeffrey H. Samet ◽  
Seonaid Nolan
Keyword(s):  
Opioid Agonist ◽  
Treatment Interventions ◽  
Opioid Agonist Treatment
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